Side Effects of HIV and AIDS Drugs

HIV medications help HIV-infected persons lead longer, healthier lives. However, AIDS and HIV drug side effects are also common. These side effects range from mild to life threatening. Here is an overview of some of the common and more severe HIV drug side effects.



Severe Side Effects of HIV Drugs

Here are examples of more severe HIV drug side effects:

Hypersensitivity reaction (HSR) can occur in genetically-susceptible persons who receive abacavir and can be life-threatening if the drug is not stopped immediately. It can be prevented by testing for this susceptibility before the drug is used. It may occur 1-6 weeks after starting the drug in susceptible persons. HSR has also been reported for some other ARV drugs.

Symptoms of HSR include:

  • Fever
  • Rash
  • Malaise
  • Headache
  • Muscle pains
  • Nausea, vomiting
  • Abdominal pain

Lactic acidosis leads to high levels of acid in the blood, which can be fatal. It can result from the use of NRTIs.

Symptoms of lactic acidosis include:

  • Long-lasting nausea, vomiting, and abdominal pain
  • Unusual fatigue
  • Shortness of breath
  • Rapid breathing
  • Enlarged or tender liver
  • Cold or blue hands and feet
  • Abnormal heart beat
  • Weight loss

Treatment of lactic acidosis may include:

  • Changing your drug regimen, but only under the guidance of your doctor
  • Intravenous fluids, possibly in the hospital
  • Vitamin supplements

Hyperglycemia occurs with higher-than-usual levels of blood sugar, called glucose. It is a symptom of diabetes. However, you can have hyperglycemia without having diabetes. Protease inhibitors, growth hormone drugs, and hepatitis C infection can increase the risk of this side effect.

Symptoms of hyperglycemia include:

  • Increased urination
  • Excessive thirst or hunger
  • Unexplained weight loss

Treatment of hyperglycemia includes:

  • Stopping protease inhibitors, but only under the guidance of your doctor
  • Hypoglycemic drugs (to lower blood sugar) taken by mouth
  • Insulin injected under the skin

Hyperlipidemia is an increase of fat in the blood. These fats include cholesterol and triglycerides. This condition can lead to heart disease and pancreatitis, an inflammation of the pancreas. Some protease inhibitors can increase this side effect.

Symptoms of hyperlipidemia do not exist. The only way to know if you have this condition is to have lab tests at least once a year.

Treatment of hyperlipidemia includes taking cholesterol-lowering drugs, such as statins or fibrates.

Lipodystrophy is also called fat redistribution. If you have it, your body produces, uses, and stores fat differently. This side effect is associated with the use of both NRTIs and PIs as well as the HIV virus itself. It is less common with the newer medications.

Symptoms of lipodystrophy include:

  • A buildup of fat in the neck or upper shoulders, belly, or breasts
  • A loss of fat in the face, arms, legs, or buttocks

Treatment of lipodystrophy may include:

  • A change in HIV drugs, but only under the guidance of your doctor
  • Egrifta is a drug given daily by injection. Side effects include joint pain, redness and rash at the site of injection, stomach pain, swelling, and muscle pain. The drug may also cause increases in blood sugar.
  • Exercise and diet changes
  • Glucophage (metformin), a drug to lower high blood sugar and help reduce abdominal fat
  • Hormone treatment (such as human growth hormone), injections of fat or synthetic material, or implants

Hepatotoxicity is liver damage. It may result from several classes of HIV drugs, including NRTIs, NNRTIs, and PIs. Liver damage may include inflammation, death of liver cells, or too much fat in the liver.

Symptoms of liver damage include:

  • Increased liver enzymes in the blood
  • Nausea or vomiting
  • Abdominal pain
  • Loss of appetite or diarrhea
  • Fatigue
  • Yellowing of skin and eyes (jaundice)
  • Enlarged liver

Treatment of liver damage includes stopping or changing HIV drugs, but only under the guidance of your doctor.

Skin rashes may range from mild to severe, covering at least 30% of the body’s skin surface area. Some are life-threatening. All classes of HIV drugs may cause this side effect.

Symptoms of severe rashes include:

  • Flat or raised red spots with blisters in the center
  • Blisters in the mouth, eyes, genitals, or other moist areas
  • Peeling skin that causes painful sores
  • Fever
  • Headache

Treatment of skin rashes includes:

  • A change in medications, but only under the guidance of your doctor
  • Antihistamine drugs
  • Hospitalization and intravenous fluids and medications for severe skin rashes


Referenced on 26/05/2021

  2. News release, FDA.
  3. U.S. Dept. of Health and Human Services: “Side Effects of Anti-HIV Medications."
  4. U.S. Dept. of Health and Human Services: “Enfuvirtide."
  5. New Mexico AIDS Education and Training Center: “Taking Current Antiretroviral Drugs."
  6. U.S. Dept. of Veterans Affairs: “Side Effects Guide."
  7. MedlinePlus: “Drugs, Supplements, and Herbal Information."
  8. WebMD Health News: “Egrifta Approved for HIV-Related Lipodystrophy."
  9. Gilead web site.

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